Can cardiac computed tomography predict cardiovascular events in asymptomatic type-2 diabetics?: results of a long term follow-up

BMC Cardiovascular Disorders

António Leitão-Marques¹  Marco Costa¹  Susana Basso²  Rui Catarino²  Andreia Fernandes¹  Joana Silva¹  Sérgio Barra¹  Paula Mota¹  Rui Providência¹  Ana Faustino¹ 

[1] Cardiology Department, Coimbra’s Hospital and University Centre – General Hospital, Coimbra, Portugal;Radiology Department, Coimbra’s Hospital and University Centre – General Hospital, Quinta dos Vales, Martinho do Bispo, Coimbra 3041-801 S, Portugal

关键词: Coronary artery disease;    Type-2 diabetes;    Cardiovascular risk;    Coronary CT angiography;    Coronary artery calcium;    Cardiac computed tomography;   

Others  :  855542
DOI  :  10.1186/1471-2261-14-2

 received in 2013-05-27, accepted in 2013-12-31,  发布年份 2014

【 摘 要 】

Background

Doubts remain about atherosclerotic disease and risk stratification of asymptomatic type-2 diabetic patients (T2DP). This study aims to evaluate the usefulness of calcium score (CS) and coronary computed tomography (CT) angiography (CTA) to predict fatal and non fatal cardiovascular events (CVEV) in T2DP.

Methods

Eighty-five consecutive T2DP undergoing CT (Phillips Brilliance, 16-slice) with CS and CTA were prospectively enrolled in a transversal case-control study. Patients were followed for 48 months (range 18 - 68) to assess CVEV: cardiovascular death, acute coronary syndrome, revascularisation and stroke. Potential predictors of CVEV were identified. Predictive models based on clinical features, CTA and CS were created and compared.

Results

Performing CT impacted T2DP treatment. Cardiovascular risk was lowered during follow-up but metabolic control remained suboptimal. CVEV occurred in 11.8% T2DP (3.1%/year). CS ≥86.6 was predictor of CVEV over time, with a high negative predictive value, an 80% sensitivity and 74.7% specificity. Although its prognostic value was not independent of the presence/absence of obstructive CAD, adding CS and CTA data to clinical parameters improved the prediction of CVEV: the combined model had the highest AUC (0.888, 95%CI 0.789-0.987, p < 0.001) for the prediction of the study endpoints.

Conclusions

CS showed great value in T2DP risk stratification and its prognostic value was further enhanced by CTA data. Information provided by CT may help predict CVEV in T2DP and potentially improve their outcome.

【 授权许可】

   
2014 Faustino et al.; licensee BioMed Central Ltd.

【 图 表 】

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